For-Profit Hospice Providers: Double Edged Sword

One of the biggest realities in the entire healthcare sector is the fact that the care for our elderly is often a second thought for the lawmakers, insurance companies and medical providers. Now, that’s not an across the board statement; however, it’s a very real concern that’s growing in every region of the nation. So what is it for-profit hospice providers deliver and could it be the one saving grace in this sector for the elderly? For profit providers are able to invest in the latest technology with no shortage of big pharma companies that are ready to try to new drugs. On the other side, profits are more of a priority than patient care – and that’s the real disgrace.

If you’ve followed the exceptional Washington Post series, Business of Dying, you know what’s at stake. The journalists behind the series were able to dig further into the laws and compliance regulations and because of that, they’ve presented a new reality that’s anything but comforting.

Hospice care is a $17 billion industry. Because the costs have shifted from communities that cared for their own, along with their area churches, the commercialization of hospice has meant big profits for those in the game and it’s costing the elderly their lives.

The scathing report found that for-profit hospice facilities spend far less on nursing care per patient, that patient has a greater chance of not seeing a medical professional in those final days and patients are far more likely to drop out of hospice care if they’re run as a for profit business (even if they’re in their final days). It’s difficult to justify the argument that care is easier accessed due to these advances when the hospice is less concerned about the patients it serves and focused on keeping costs down.

In other words, what many are experiencing hospice care as anything but what it was designed to do.

The Medicaid and Medicare Dynamic

So how does Medicaid and Medicare play into this? WaPo analyzed data from Medicare records from 2013 and then mirrored it to the hospice records for the same time period. It found that “the gap between the for-profits as a whole and nonprofits is striking and consistent, regardless of hospice size”.

Here for the Money

It’s not surprising that many of these companies are focused on one thing alone: profits. “A lot of the problems we have in hospice today have happened with the entry of what I call the ‘vulture capitalists.’ ” explained Michael Girard, owner of the Circle of Life for-profit hospice in Reno

With new polls suggesting half of Americans will require hospice care before death, there remains a significant shortage of information on the role hospice plays. Part of this is because of those who are there for the money and with no interest in educating the communities they’re in. Not only that, many consumers have no idea which hospices are for profit and which are nonprofit. And if it’s difficult to find that bit of information, imagine the obstacles that come with finding those that are focused on the right things: the quality of care of the patient.

A few of these differences can highlight the types of flags you’re looking for:

Nonprofit hospices typically spent about $36 a day per patient on nursing visits; for-profit hospices spent $30 per day, or 17 percent less. Due diligence matters!

Those non-profit models put around-the-clock nursing and inpatient care ahead of everything else. The study found that nonprofits offered these intense services ten times the rate as for profits facilities.

Be sure there will be a nurse who’s available and visiting often in those final days.

Finally, ask for referrals from family and friends who’ve already familiarized themselves with your local hospice care facilities.

As always, our estate planning and elder law attorneys stand ready to provide guidance and to help ensure your planning is complete.

Ellen LaPlante is an attorney whose mission is to provide clients with guidance in Estate Planning, Elder Law, and Medicaid Preparation. She is barred in Vermont and New York. Ellen helps clients put together unique estate plans, including assistance with Trusts, Wills, Powers of Attorney, and Advance Directives. She also works with clients on Medicaid Planning and qualifying for Medicaid assistance.

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